Northern Ireland services need radical change, politicians told

 At a meeting with a cross-party group of MLAs at Stormont in January, Department of Health permanent secretary Richard Pengelly said 2018 would be another difficult year for local services. Winter pressures were intense and unlikely to ease for a number of weeks, though an additional £10m had been found to mitigate the pressure. Co-operation across health and social care (HSC) was also helping, he added.

‘Much more radical action is needed,’ he told MLAs. ‘We cannot consign our hospitals to a future where winter pressures simply intensify year on year, and the whole HSC system becomes steadily more unsustainable. There are no easy or short-term solutions but we owe it to patients and our great staff to start making it better.’

Transformation, backed with strategic investment in staffing and capacity, was the key to addressing winter pressures and other serious problems. ‘We need to build up domiciliary care and other aspects of social care, enhance primary care to help people stay well and reshape our hospital services,’ he added.

Projections from the Department of Finance showed health funding shortfalls of £151m-£171m in 2018/19 and £265m-£340m in 2019/20 under different funding scenarios.

The scenarios aim to inform an incoming executive’s discussions on balancing the overall budget. Health funding would rise by 4.6% to 7% under the scenarios, but the Department insisted the figures were for illustration and no decisions had been made. The North has been without an executive for about a year.

The three scenarios include: a Budget approach broadly in line with 2016/17 and 2017/18 (with extra funding going to health and education); raising funds through additional charges or reviewing existing policies; and reallocating funds to priorities such as schools and health.

 The HFMA has issued a briefing examining the differences in per capita healthcare funding between Northern Ireland and England. The document – which presents its findings for debate, not as a statement of what funding levels should be – found a £540m gap between the modelled need and actual funding in 2015.